 |
|
|
 |
 |
|
|
|
If you have been denied benefits and disagree with this decision, you may ask for an appeal. Contact your worker at the Department of Social Services who sent the letter denying benefits. If you are uncertain whom to call, contact the CARE-LINE Information and Referral Service at 1-800-662-7030 or 919-855-4400.
If a Medicaid health service is denied (or if it is reduced, terminated, or suspended), you will receive a letter. The letter will come from the N.C. Division of Medical Assistance, or one of its vendors. The vendors are EDS, Value Options, and ACS. The letter describes the decision and why it was made. You have the right to appeal. The letter has instructions for how to appeal.
To learn more about the hearing process, call the Appeals Unit, Division of Medical Assistance at 919-855-4260. You may also call the toll free CARE-LINE Information and Referral Service at 1-800-662-7030 or 919-855-4400 and request that your call be transferred.
Medicaid recipients are entitled to have their medical information be kept private. See Notice of Privacy Practices (DMA-2188).
A federal law requires Medicaid to provide all medically necessary health care services to Medicaid-eligible children. This is called Early Periodic Screening, Diagnostic and Treatment (EPSDT), or Health Check. The services are required even if the services are not normally covered by children's Medicaid.
If you are 18 are older, and able to communicate and make health care decisions, you have the right to make decisions about your medical and mental health treatment. The Medical Care Decisions and Advance Directive brochure outlines the steps that you can take to control decisions about your medical and mental health treatment should you become unable to make or express those decisions on your own.
If you are a Community Care of North Carolina/Carolina ACCESS (CCNC/CA) member, you have a right to make a complaint if you think your primary doctor has not provided good care.
read more about CCNC/CA Complaints >>
